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School Accident Benefit

Pay for out-of-pocket expenses

If your child is in an Accident at school, School Accident Benefit helps pay for out-of-pocket expenses relating to extras included in your cover. Check your Product Summary to see if you are entitled to the School Accident Benefit. Waiting periods, annual limits and the following conditions apply.

A School Accident Benefit will be payable:

If a Child Dependant attending before and after school care, primary or secondary school receives General Treatment covered under their product as a result of an Accident that occurred;
(i) at school; or
(ii) on the way to-or-from school; or
(iii) on the way to-or-from a school activity; or
(iv) at approved and regulated before and after school care;

To cover out-of-pocket expenses (cost of service minus the HCF Benefit for that item) incurred for General Treatment due to a School Accident which occurred after joining up to the annual limit per Dependent Child per Calendar Year;

To top up any General Treatment services that are included in your extras cover at date of service (hospital and medical services are excluded);

Should the annual limit for the service being claimed be reached, School Accident Benefits may be paid over and above the child’s annual limit for that service;

If the Dependent Child receives General Treatment within 12 months from the date of the Accident

For up to a 24 month period from the date of the Accident (applies to Platinum, Gold, Ultimate, Lifestyle Plus and Active Lifestyle extras);

If the child is an HCF member with an extras cover that includes School Accident Benefit at the time of the School Accident;

If a completed claim form and receipts are accompanied by a detailed description of the School Accident from the school, including the extent and circumstances of the injury. The report must be on the school’s letterhead;

When waiting periods have been served. The waiting period for School Accident Benefits is the same as the waiting period for the General Treatment being claimed; and